Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003095100 |
---|---|
Provider Name | Mrs. Yvette Denine Arey |
First Address | Portland, OR 97207-9823 |
Second Address | Portland, OR 97207-9823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2007 |
Last Update Date | 25/10/2007 |